Ophthalmology Quiz: Corneal Abrasion and Uveitis

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Questions and Answers

What are the cardinal signs of bacterial keratitis?

Decreased corneal sensation

Presence of keratin precipitates

Ciliary injection

Diffuse central infiltration of the corneal epithelial and stroma (correct)

Why are topical steroids contraindicated in cases of viral corneal ulcers?

They suppress the immune response (correct)

They reduce inflammation

They enhance the immune response

They promote healing of the cornea

What is a common cause of bacterial keratitis in contact lens wearers?

Corneal trauma (correct)

Viral infection

Pre-existing cataracts

Exposure to UV light

What is a typical treatment for anterior uveitis?

Topical steroids and cycloplegics (B) Signup and view all the answers

What condition is associated with ectopia lentis?

Homocysteinuria (C) Signup and view all the answers

What phenomenon may occur due to unilateral aphakia with corrective glasses?

Anisocoria (B) Signup and view all the answers

What is associated with granulomatous uveitis?

Darkly pigmented keratin precipitates (A) Signup and view all the answers

What happens to the lens capsule after cataract surgery?

It can become opacified due to epithelial cell proliferation (A) Signup and view all the answers

What is the primary purpose of focal laser therapy?

To peg down retinal tears and address leaking vessels (C) Signup and view all the answers

What is the earliest sign of non-proliferative diabetic retinopathy?

Microaneurysms (C) Signup and view all the answers

Which is the most common cause of blindness in the western world?

Age-related macular edema (A) Signup and view all the answers

What is a characteristic symptom of retinal detachment?

Seeing floaters, curtains, or shadows (A) Signup and view all the answers

Which risk factor does NOT contribute to retinal detachment?

Hyperopia (B) Signup and view all the answers

What is the management method for rhegmatogenous retinal detachment?

Scleral buckling or pneumatic retinopexy (B) Signup and view all the answers

What is the most common cause of floaters and flashes in the vision?

Posterior vitreous detachment (A) Signup and view all the answers

What happens when posterior vitreous detachment occurs?

Bleeding can occur as the vitreous gel pulls away (D) Signup and view all the answers

What is the characteristic appearance of the retina in central retinal vein occlusion?

Thunderstorm appearance with flame-shaped hemorrhages (C) Signup and view all the answers

What is a key finding in hypertensive retinopathy?

Cotton wool spots as the earliest finding (B) Signup and view all the answers

Which condition is primarily characterized by abnormal neovascularization of the retina in preterm infants?

Retinopathy of prematurity (C) Signup and view all the answers

In what condition would you expect the presence of AV nicking?

Hypertensive retinopathy (A) Signup and view all the answers

How is central retinal artery occlusion typically presented in contrast to central retinal vein occlusion?

Sudden vision loss (D) Signup and view all the answers

What visual field perception does the nasal retina provide?

Temporal visual field (A) Signup and view all the answers

Which finding is typically associated with Cytomegalovirus (CMV) retinitis?

Yellow white exudates adjacent to fovea (B) Signup and view all the answers

What does optic disk swelling indicate when observed during an examination?

Papilledema, CRVO, and hypertensive retinopathy (C) Signup and view all the answers

What happens to both pupils when light is shone on the affected eye in relative afferent pupillary defect?

Both pupils dilate (A) Signup and view all the answers

Which of the following is a common cause of relative afferent pupillary defect?

Amylopia (C) Signup and view all the answers

What is the most common tumor of the eyelid?

Papilloma (D) Signup and view all the answers

Which statement is true regarding metastases in the retina?

The retina is the least commonly involved due to the blood-retinal barrier (A) Signup and view all the answers

What is the most common intraocular tumor in children?

Retinoblastoma (A) Signup and view all the answers

What is the preferred management for lentigo malignant?

Surgery with safe margins (D) Signup and view all the answers

What is the primary means of treating skin SCC (squamous cell carcinoma)?

Surgery (B) Signup and view all the answers

Which test is used to diagnose anterior instability of the shoulder?

Anterior apprehension test (B) Signup and view all the answers

What is the preferred treatment for a midshaft femur fracture?

Plate and screw fixation (B) Signup and view all the answers

In which situation is total hip replacement indicated?

Subluxation of the hip joint (A) Signup and view all the answers

What is the appropriate initial action for an open displaced fracture?

Disinfect and debride (D) Signup and view all the answers

A popliteal cyst is most commonly caused by which condition?

Extrusion of synovial fluid (B) Signup and view all the answers

What symptom is associated with a quadriceps tendon tear?

Inability to extend the knee (D) Signup and view all the answers

Which test is specifically for assessing injury to the Achilles tendon?

Thompson test (B) Signup and view all the answers

What condition is indicated by apparent leg length discrepancy?

Issues above the hip joint (D) Signup and view all the answers

Which ligament injury causes an inability to plantar flex the foot?

Anterior talofibular ligament (A) Signup and view all the answers

Study Notes

Corneal Abrasion

Topical steroids are contraindicated in cases of viral corneal ulcers because they suppress the immune response, which can lead to a worsening of the infection, thinning of the cornea, and an increased risk of corneal ulceration.
Herpes simplex causes decreased corneal sensation.
Bacterial keratitis usually occurs in contact lens wearers after corneal trauma or entry of a foreign body.
The cardinal signs of bacterial keratitis are diffuse central infiltration of the corneal epithelium and stroma.

Uveitis

Uveitis involves inflammatory cells in the aqueous humor/anterior chamber.
Anterior uveitis is usually unilateral.
Anterior uveitis is treated with topical steroids and cycloplegics.
Granulomatous uveitis is associated with darkly pigmented keratic precipitates.
Ciliary injection is seen in chronic iridocyclitis.
Ciliary flush helps differentiate between iritis and conjunctivitis.

Lens

The anterior lens epithelium (germinative zone) is responsible for epithelial cell division and gives rise to new lens fibers.
Ectopia lentis is seen with homocysteinuria.
Superior lens subluxation can cause monocular diplopia.
Correction of unilateral aphakia (no lens) with glasses will cause anisocoria (pupils of different sizes).

Cataract

After cataract surgery, the lens capsule can become opacified due to proliferation and migration of lens epithelial cells, particularly from the equatorial region of the lens.

Retinal Disorders

Although some of the retina is sacrificed in PRP, it is worth saving the central vision.
Focal laser therapy is used to peg down retinal tears and help with leaking vessels.
Metamorphosis is a feature of non-proliferative macular edema.
First-line treatment for diabetic retinopathy is Anti-VEGF therapy.
Microaneurysms are the earliest sign of non-proliferative diabetic retinopathy.
Hard exudate is the accumulation of lipid in the outer plexiform layer.
Diabetic retinopathy is the most common cause of blindness in KSA.
Age-related macular degeneration is the most common cause of blindness in the Western world.
Diabetes is the most common cause of vitreous hemorrhage.
Check for diabetic retinopathy immediately at diagnosis of type 2 diabetes, and 5 years after diagnosis of type 1 diabetes.
High myopia is a risk factor for retinal detachment; hyperopia does not contribute.
Cataract surgery is a risk factor for rhegmatogenous retinal detachment.
Scleral buckling surgery is the best treatment for rhegmatogenous retinal detachment.
Rhegmatogenous retinal detachment is managed by closing the retinal defect (scleral buckling, pneumatic retinopexy).
Retinal detachment is often associated with low IOP as a result of increased outflow by active pumping of fluid through the exposed retinal pigment epithelium.
Retinal detachment presents with floaters, curtains, and shadows.
The most common cause of floaters and flashes is posterior vitreous detachment (PVD).
Vitreous hemorrhage has a sudden onset of symptoms, is usually unilateral and painless, with floaters and visual loss that is typically worse after sleep.
Vitreous hemorrhage can occur with proliferative diabetic retinopathy, proliferative retinopathy following vascular occlusion and vasculitis, trauma, retinal breaks, and posterior vitreous detachment without retinal breaks.
Simple retinal detachment does not involve posterior vitreous detachment.
Posterior vitreous detachment occurs when the vitreous gel pulls away from the retina.
When PVD occurs, bleeding can occur as the vitreous gel pulls away, causing holes or tears in the retina.
Swollen optic disc is due to ischemic optic neuropathy.
Central retinal vein occlusion (CRVO) presents with a "thunderstorm appearance," meaning it involves spots, flame hemorrhages, and tortuous veins.
CRVO causes gradual vision loss, while central retinal artery occlusion (CRAO) causes sudden vision loss.
In CRVO, fundoscopy reveals focal retinal hemorrhages instead of a pale white retina, as seen in CRAO.
Retinopathy of prematurity involves abnormal neovascularization of the retina in preterm infants.
Hypertensive retinopathy results in AV nicking, flame-shaped hemorrhages, and exudates. Cotton wool spots are the earliest finding.
Hypertension can cause sudden painless vision loss by occlusion of the central retinal artery or vein.
The presence of several yellow-white exudates adjacent to the fovea and retinal vessels is characteristic of CMV retinitis. AIDS patients, particularly those with CD4 counts < 50 cells, are at high risk of CMV retinitis.
Optic disc swelling can occur with papilledema, CRVO, and hypertensive retinopathy.
Retinitis pigmentosa may be caused by a null mutation in autosomal dominant cases.
Rod-cone dystrophy is more severe than cone-rod dystrophy.

Visual Field

The nasal retina perceives light from the temporal visual field. The temporal retina perceives light from the nasal visual field.
The lower retina perceives light from the upper visual field.
Marcus Gunn pupil is a pupillary defect that affects the afferent arm of the pupillary response.
In relative afferent pupillary defect (RAPD), both pupils dilate when light is shone on the affected eye.
Amblyopia is one of the causes of RAPD.
Polycoria is multiple pupils.
O-centered pupils are corectopia.

Tumors of the Eye and Skin

Papilloma is the most common tumor of the eyelid.
The retina is the least commonly involved in metastases because of the blood-retinal barrier.
Rhabdomyosarcoma is the most common orbital (not ocular) malignancy in children.
Retinoblastoma is the most common intraocular tumor in children. Biopsy of retinoblastoma shows exner-wintersteiner bodies.
If a child has asymmetrical red reflex, perform a dilated fundoscopic exam.
Choroidal melanoma is the most common intraocular tumor in adults.
Lentigo maligna management is surgery with safe margins.
Malignant melanoma of the eyelid skin can be treated with cryotherapy, but the first-line treatment is excision with wide margins.
The lower eyelid is the most common location of basal cell carcinoma (BCC).
Surgery is the primary treatment for squamous cell carcinoma (SCC) of the skin.
Eye surgery is associated with bullous keratopathy complications.

Orthopedics

Anterior instability of the shoulder can be diagnosed by the anterior apprehension test. The anterior apprehension test is used to assess for shoulder dislocation.
The Speed test is used to diagnose long head of the biceps tendinitis.
Midshaft femur fractures are treated by plate and screw fixation.
Hemiarthroplasty replaces the fractured femoral head with a prosthetic implant. It is commonly performed in elderly women with displaced or unstable femur neck fractures, while preserving the native acetabulum.
If there is subluxation, perform a total hip replacement because the acetabular component has degenerated too much.
If a patient has an open displaced fracture, disinfect, debride, and perform external fixation.
If a patient has a closed, displaced fracture, perform open reduction internal fixation (ORIF).

Developmental Dysplasia of the Hip (DDH)

Apparent leg length discrepancy occurs due to issues above the hip joint, such as pelvic obliquity, scoliosis, or muscle contractures, which makes one leg appear shorter than the other.

Knee Injury and Special Tests

Quadriceps tendon tear causes inability to extend the knee with a low lying patella.
A popliteal cyst is due to extrusion of synovial fluid from the knee joint into the gastrocnemius or semimembranous bursa through the communication between the joint and the bursa.
Excessive synovial fluid production (due to osteoarthritis or rheumatoid arthritis) and positive pressure in the knee during extension can cause passage of the fluid into the bursa and gradual enlargement of the cyst.
Popliteal cysts are often asymptomatic and present as a chronic painless bulge behind the knee.
The diagnosis is usually apparent on examination with a soft tissue mass in the medial popliteal space that is most noticeable with knee extension and less prominent with flexion.
Rupture of a popliteal cyst can cause posterior knee and calf pain with tenderness and swelling in the calf resembling deep vein thrombosis (DVT). An arc of ecchymosis is often visible distal to the medial malleolus (crescent sign).
Ultrasound (US) can rule out DVT and confirm a popliteal cyst.

Foot and Ankle Injury

Injury to the anterior talofibular ligament causes inability to plantar flex.
The Thompson test is used to assess for injury to the Achilles tendon.

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Description

Test your knowledge on corneal abrasions, uveitis, and lens anatomy in this comprehensive ophthalmology quiz. Explore contraindications for topical steroids, signs of bacterial keratitis, and treatment options for anterior uveitis. Perfect for students and professionals in the medical field!